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Biomedical subjects

J Udupa

Publications and source records attributed to J Udupa.

9 recordsLinked to original sources
PubMed2000

Atrophy and high intensity lesions: complementary neurobiological mechanisms in late-life major depression.

The primary objective of our study was to examine the role of atrophy, high intensity lesions and medical comorbidity in the pathophysiology of major depressive disorder in the elderly (late-life MDD). Our sample was comprised of 51 patients with late-life MDD and 30 non-depressed controls. All subjects were scanned on 1.5 tesla magnetic resonance imaging scanner (MRI) and absolute and normalized measures of brain and lesion volumes were obtained and used for comparison between groups. Patients with MDD had significantly smaller frontal lobe volumes, together with larger whole brain lesion volumes when compared with controls (p < .05). Whole brain lesion volumes correlated significantly (r = 0.41, p = .006) with overall medical comorbidity. The odds ratio (OR) for existing MDD increases significantly with a decrease in frontal lobe volume and an increase in whole brain lesion volumes (p < .05). Our findings suggest that atrophy and high intensity lesions represent relatively independent pathways to late-life MDD. While medical disorders lead to neuropathological changes that are captured on MR imaging as high intensity signals, atrophy may represent a relatively autonomous phenomenon. These findings have broad implications for the pathophysiology of mood disorders and suggest that complementary neurobiological processes may lead to cumulative neuronal injury thereby predisposing to clinical depression.

Age of Onset↗
PubMed1999

Age of onset of depression and quantitative neuroanatomic measures: absence of specific correlates.

The purpose of our study was to examine the relationship between volumetric neuroanatomic measures and age of onset of illness in subjects with late-life major depression. Our sample was composed of 51 elderly subjects with Major Depressive Disorder who were scanned using a 1.5-tesla GE magnetic resonance imaging scanner with head coil. Absolute total and focal brain volumes were obtained together with quantified estimates of high intensity lesions. The relationship of these measures to onset age was examined using a regression while adjusting for subjects' current age and total intracranial volume. There was no significant linear relationship between age of onset of the first episode and any of the neuroanatomic measures examined. These data do not support the notion that neuroanatomical contributions to depression increase with a later age of onset of illness.

Brain↗
PubMed1999

Familial multiple sclerosis: volumetric assessment in clinically symptomatic and asymptomatic individuals.

A genetic basis for clustering of multiple sclerosis (MS) cases, based on studies of MS families, has been proposed for decades. Few reports provide detailed neurological as well as neuroradiological findings on these patients. We report total T2-weighted intracranial lesion volumes on members of three familial MS cohorts: a mother and father with conjugal MS with one affected son and a neurologically normal son and daughter, one pair of monozygotic twin sisters with MS, and a female sibling pair with MS. We hypothesized that asymptomatic siblings in a family with two affected parents and another affected child might demonstrate clinically silent T2-weighted lesions; and that monozygotic twins with MS are more likely to express similar T2-weighted lesion volumes than non-twin sibling pairs. We found clinically silent lesions in unaffected children of the symptomatic parent couple, with a significant difference in total T2 lesion volume between these unaffected siblings and their parents, as well as their affected brother. In our other sibling pairs, T2 lesion volumes were similar between the twins and significantly different in the non-twin pair, despite similar levels of clinical functioning as determined by EDSS scoring. These results suggest that foci of demyelination might be expected in clinically normal offspring of parents with MS, possibly reflecting a genetic predisposition to subsequent development of MS.

Adult↗
PubMed1998

Late-onset minor and major depression: early evidence for common neuroanatomical substrates detected by using MRI.

The purpose of our study was to examine the neuroanatomical correlates of late-onset minor and major depression and to compare them with similar measures obtained from nondepressed controls. Our study groups were comprised of 18 patients with late-onset minor depression, 35 patients diagnosed with late-onset major depression, and 30 nondepressed controls. All subjects were scanned by using a 1. 5-tesla MRI scanner. Absolute whole brain volume and normalized measures of prefrontal and temporal lobe volumes were obtained and used for comparison among groups. Our findings indicate that patients with minor depression present with specific neuroanatomical abnormalities that are comparable with the major depression group but significantly different from the controls. Normalized prefrontal lobe volumes show a significant linear trend with severity of depression, with volumes decreasing with illness severity. Whole brain volumes did not differ significantly among groups. These findings have broad implications for the biology of late-life depression and suggest that there may be common neurobiological substrates that underlie all clinically significant forms of late-onset mood disturbances.

Aged↗
PubMed1998

Total brain N-acetylaspartate concentration in normal, age-grouped females: quantitation with non-echo proton NMR spectroscopy.

The intra-individual and inter-individual variations of the global N-acetylaspartate (NAA) concentration were measured in a cohort of five 42+/-5 year-old normal females. The total NAA signal from the whole head was obtained with non-localized non-echo proton spectroscopy (1H-MRS) and converted into absolute mole amounts using phantom replacement. Since NAA is assumed to be present only in neurons, its concentration was obtained by dividing these mole amounts with the brains' volume, calculated from high resolution MRI. The key feature of the procedure is its near-complete suppression of the intense subcutaneous and bone marrow lipids' signals, whose chemical shifts neighbor and underlay the NAA. This was achieved by exploiting the lipids' much shorter T1s, compared to that of NAA, for destructive interference of their signals in co-addition following alternating, nonselective 180 degrees inversions. The average global, inter-individual NAA concentration in that group was found to be 10.63 mM with a 95% confidence interval of 10.43-10.82 mM.

Adult↗
PubMed1985

Identification of an anteriorly displaced meniscus in vitro by means of three-dimensional image reconstructions.

Computerized tomography has some limitations for diagnosis of internal derangements of the TMJ. The use of three-dimensional image reconstructions of CT data may enhance the diagnostic utility of CT. In a cadaver simulation, three-dimensional imaging was able to demonstrate the location of a displaced meniscus which was not obvious in two-dimensional sections. Location of the meniscus was aided by the use of a "transparency mode" in displaying the data.

Cartilage, Articular↗
PubMed1984

Three-dimensional imaging and display of the temporomandibular joint.

Despite recent advances in diagnostic radiology, current techniques for radiographic evaluation of the temporomandibular joint continue to present the clinician with difficult problems in interpretation and diagnosis. The use of three-dimensional images reconstructed from computed tomographic (CT) data improves the diagnostic value of conventional CT at no additional risk to the patient and may provide new insights into this complex anatomic structure. A sequence of 1.5 mm CT sections is made with a slice-to-slice spacing of 1.0 mm. These are used to construct a new sequence of slices by mathematical interpolation in which the new slice spacing equals the size of the pixels. Structures to be imaged separately are then masked in the interpolated sections prior to "windowing" for the appropriate tissue density. A special algorithm detects the boundary surface of the selected structure. The surface pixels are assigned gray levels on the basis of their distance and attitude from the observer. When displayed, this produces a simulated three-dimensional image. The image can be rotated and sectioned. Rotations permit otherwise hidden surfaces to be examined. Images of a human temporomandibular joint in vitro are presented to demonstrate (1) the bony components of the joint and their relationships within the joint; (2) the bony components separated to display hidden surfaces; and (3) the joint meniscus in situ and as a separate component.

Cadaver↗
PubMedDate not supplied

MR lesion load and cognitive function in patients with relapsing-remitting multiple sclerosis.

BACKGROUND AND PURPOSE: Multiple sclerosis (MS) is a demyelinating disease most often associated with progressive physical impairment; however, its effects are noted to extend beyond physical disability. Our purpose was to determine the relationship between T2 lesion volume and neurocognitive and physical disability in relapsing-remitting multiple sclerosis. METHODS: We studied a cohort of 19 patients with relapsing-remitting MS. Of this group, there were 15 women and four men from varying socioeconomic backgrounds. This volunteer sample was selected from a larger group of 53 patients with MS in our longitudinal MS study because they had been untreated with any beta-interferon medications, had been followed for at least 12 months, and had a clinical status of relapsing-remitting MS. RESULTS: Of 12 neurocognitive parameters tested, two correlated significantly with lesion loads. The correlation of the Symbol-Digit Modalities test, which analyzes information-processing speed, was significant (P = .0204). The correlation of the fifth trial of the Rey Auditory Verbal Learning test, which tests verbal long-term memory, was also significant (P = .0348). None of the other 10 neurocognitive examinations, however, showed a significant correlation with total lesion volume (Paced Auditory Serial Addition test-1.6, P = .7381; Paced Auditory Serial Addition test-2.0, P = .4180; Controlled Oral Word Association test, P = .8906; Category Fluency test, P = .4423; Bells test, P = .9097; Rey Auditory Verbal Learning test-delay, P = .9843, Rey Auditory Verbal Learning test-recognition, P = .7467; Word Span test, P = .4939; Road Map test, P = 0.4939). The lesion load also did not correlate with the physical disability scales as rated according to the Expanded Disability Status Scale (P = .68) or Ambulation Index (P = .95). CONCLUSION: Our results indicate that T2 lesion volume does not seem to be a robust surrogate marker of neuropsychological impairment in patients with MS. We think that global measurements of parameters that are more specific to the disease process may offer more precise correlation with cognitive dysfunction and other disability parameters.

Adult↗